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Predictors of Early Neurological Improvement in Patients with Anterior Large Vessel Occlusion and Successful Reperfusion Following Endovascular Thrombectomy—Does CT Perfusion Imaging Matter?
PURPOSE: We aimed to investigate treatment effect of endovascular thrombectomy (EVT) on the change of National Institutes of Health Stroke Scale (NIHSS) scores in acute ischemic stroke (AIS) patients with anterior large vessel occlusion (LVO). Predictors of early neurological improvement (ENI) were...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9424155/ https://www.ncbi.nlm.nih.gov/pubmed/35244728 http://dx.doi.org/10.1007/s00062-022-01147-0 |
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author | Li, Yan van Landeghem, Natalie Demircioglu, Aydin Köhrmann, Martin Kellner, Elias Milles, Lennart Stolte, Benjamin Totzeck, Andreas Dammann, Philipp Wrede, Karsten Theysohn, Jens Matthias Styczen, Hanna Forsting, Michael Wanke, Isabel Frank, Benedikt Deuschl, Cornelius |
author_facet | Li, Yan van Landeghem, Natalie Demircioglu, Aydin Köhrmann, Martin Kellner, Elias Milles, Lennart Stolte, Benjamin Totzeck, Andreas Dammann, Philipp Wrede, Karsten Theysohn, Jens Matthias Styczen, Hanna Forsting, Michael Wanke, Isabel Frank, Benedikt Deuschl, Cornelius |
author_sort | Li, Yan |
collection | PubMed |
description | PURPOSE: We aimed to investigate treatment effect of endovascular thrombectomy (EVT) on the change of National Institutes of Health Stroke Scale (NIHSS) scores in acute ischemic stroke (AIS) patients with anterior large vessel occlusion (LVO). Predictors of early neurological improvement (ENI) were assessed in those with successful reperfusion. METHODS: Data on stroke patients from January 2018 to December 2020 were retrospectively analyzed. Anterior LVO was defined as occlusion of internal carotid artery and/or M1/M2 branch of middle cerebral artery. A reduction of at least 8 NIHSS points at 24 h after EVT or NIHSS score ≤ 1 at discharge was defined as ENI. In patients with successful reperfusion (TICI score of 2b/3) and available CT perfusion (CTP) imaging, 20 variables were tested in a smoothed ridge regression for their association with ENI. RESULTS: One hundred seventy two out of 211 patients had successful perfusion with 54 patients achieving ENI. Impact of successful EVT on reducing NIHSS score grew continuously on a daily basis up to the date of discharge. 105 out of 172 patients were included in final regression model. Short time from onset to admission and from groin-puncture to reperfusion, young age, low prestroke disability, high baseline CTP ASPECTS and high follow-up non-contrast CT (NCCT) ASPECTS were significantly associated with ENI. Neither baseline NCCT ASPECTS nor the volume of penumbra or ischemic core measured on CTP were associated with ENI. CONCLUSION: CTP ASPECTS might better predict ENI than non-contrast CT at baseline in patients with successful reperfusion following EVT. |
format | Online Article Text |
id | pubmed-9424155 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-94241552022-08-31 Predictors of Early Neurological Improvement in Patients with Anterior Large Vessel Occlusion and Successful Reperfusion Following Endovascular Thrombectomy—Does CT Perfusion Imaging Matter? Li, Yan van Landeghem, Natalie Demircioglu, Aydin Köhrmann, Martin Kellner, Elias Milles, Lennart Stolte, Benjamin Totzeck, Andreas Dammann, Philipp Wrede, Karsten Theysohn, Jens Matthias Styczen, Hanna Forsting, Michael Wanke, Isabel Frank, Benedikt Deuschl, Cornelius Clin Neuroradiol Original Article PURPOSE: We aimed to investigate treatment effect of endovascular thrombectomy (EVT) on the change of National Institutes of Health Stroke Scale (NIHSS) scores in acute ischemic stroke (AIS) patients with anterior large vessel occlusion (LVO). Predictors of early neurological improvement (ENI) were assessed in those with successful reperfusion. METHODS: Data on stroke patients from January 2018 to December 2020 were retrospectively analyzed. Anterior LVO was defined as occlusion of internal carotid artery and/or M1/M2 branch of middle cerebral artery. A reduction of at least 8 NIHSS points at 24 h after EVT or NIHSS score ≤ 1 at discharge was defined as ENI. In patients with successful reperfusion (TICI score of 2b/3) and available CT perfusion (CTP) imaging, 20 variables were tested in a smoothed ridge regression for their association with ENI. RESULTS: One hundred seventy two out of 211 patients had successful perfusion with 54 patients achieving ENI. Impact of successful EVT on reducing NIHSS score grew continuously on a daily basis up to the date of discharge. 105 out of 172 patients were included in final regression model. Short time from onset to admission and from groin-puncture to reperfusion, young age, low prestroke disability, high baseline CTP ASPECTS and high follow-up non-contrast CT (NCCT) ASPECTS were significantly associated with ENI. Neither baseline NCCT ASPECTS nor the volume of penumbra or ischemic core measured on CTP were associated with ENI. CONCLUSION: CTP ASPECTS might better predict ENI than non-contrast CT at baseline in patients with successful reperfusion following EVT. Springer Berlin Heidelberg 2022-03-04 2022 /pmc/articles/PMC9424155/ /pubmed/35244728 http://dx.doi.org/10.1007/s00062-022-01147-0 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Li, Yan van Landeghem, Natalie Demircioglu, Aydin Köhrmann, Martin Kellner, Elias Milles, Lennart Stolte, Benjamin Totzeck, Andreas Dammann, Philipp Wrede, Karsten Theysohn, Jens Matthias Styczen, Hanna Forsting, Michael Wanke, Isabel Frank, Benedikt Deuschl, Cornelius Predictors of Early Neurological Improvement in Patients with Anterior Large Vessel Occlusion and Successful Reperfusion Following Endovascular Thrombectomy—Does CT Perfusion Imaging Matter? |
title | Predictors of Early Neurological Improvement in Patients with Anterior Large Vessel Occlusion and Successful Reperfusion Following Endovascular Thrombectomy—Does CT Perfusion Imaging Matter? |
title_full | Predictors of Early Neurological Improvement in Patients with Anterior Large Vessel Occlusion and Successful Reperfusion Following Endovascular Thrombectomy—Does CT Perfusion Imaging Matter? |
title_fullStr | Predictors of Early Neurological Improvement in Patients with Anterior Large Vessel Occlusion and Successful Reperfusion Following Endovascular Thrombectomy—Does CT Perfusion Imaging Matter? |
title_full_unstemmed | Predictors of Early Neurological Improvement in Patients with Anterior Large Vessel Occlusion and Successful Reperfusion Following Endovascular Thrombectomy—Does CT Perfusion Imaging Matter? |
title_short | Predictors of Early Neurological Improvement in Patients with Anterior Large Vessel Occlusion and Successful Reperfusion Following Endovascular Thrombectomy—Does CT Perfusion Imaging Matter? |
title_sort | predictors of early neurological improvement in patients with anterior large vessel occlusion and successful reperfusion following endovascular thrombectomy—does ct perfusion imaging matter? |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9424155/ https://www.ncbi.nlm.nih.gov/pubmed/35244728 http://dx.doi.org/10.1007/s00062-022-01147-0 |
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